It seems the most common problem for working and pumping moms is maintaining a good milk supply - or, more accurately
- getting enough milk when you are pumping. Read on for a LOT of helpful tips.

1. If there’s any
way at all, just send what you pump. Nurse right when you drop your baby off and
again as soon as you pick up - this means you have to pump for fewer missed feedings. If you can get to your daycare at lunch
to nurse, squeeze that in for a few days. Tell the daycare provider (DCP) not to feed for 1.5 hours before you get there,
or if your baby is screaming starving, just give a couple ounces to stave off the hunger. They may not want to do this –
but you can sometimes help them in this endeavor (I don’t want to say “trick them”, but that’s really
what I mean) by sending the milk in a larger number of smaller bottles, so they have the satisfaction of getting the baby
to ‘finish’ the bottle. Just cutting the bottles down by ½ ounce can make a difference!

Also - print out this handout from kellymom.com to be sure your baby is not being overfed.

2. Add a pumping session
or two. Your goal here is to have what comes out of your breasts match exactly what goes into your baby’s belly. Maybe
not every single day, but over the course of one week you should be balanced within about an ounce. (unless you’re pumping
more than the baby is eating, then pump pump away!) I had terrific luck adding a pumping session right when I got to work.
I would nurse at drop off, drive the 15 minutes to work, then pump right away. I got to work 15 minutes early to do this,
so it didn’t even count as an extra break, which was nice – and appreciated by my boss. Seems silly to pump right
after nursing, but your prolactin levels are highest in the morning, so your milk supply is usually pretty strong. Also, if
you don’t have results right away, keep at it. The extra stimulation (especially at the same time each day) tells your
body that more milk is needed. Within a week, you should see more production at this session. How else can you add more pumping
time? Here are some things other moms have tried, in no particular order:- pump in the morning right before the baby wakes
up.

- in the morning, wake
the baby to nurse, then put them back to sleep.Then have a nice relaxing shower
and pump – in either order.Get baby up for daycare, and nurse again before
you leave them off.- set an alarm and pump at 3am if your baby is sleeping through the night- pump one side while
feeding the other at the morning feeding- add in an extra pumping session during the day- add 5 minutes to each pumping
session during the day and go for a second letdown.- pump once a day on the weekend to collect a little more milk and
signal to keep supply up.

3. Nurse your baby more. If your baby is hungry
at the end of the day, this is terrific. Go home, settle in on the couch, and nurse as much as possible. This is easier with
a first baby and a cooperative partner at home, but try to boost the amount of nursing you do when you’re together.
Some ideas: - nurse right when you pick your baby up from daycare (at daycare)- wake your baby up to nurse before
you go to bed- be sure you allow for plenty of time to nurse in the morning- make every weekend a nursing holiday,
and allow your baby to nurse as often as they want to.- encourage your baby to nurse more at night. This can result in
more sleeping and less feeding during the day (called ‘reverse cycling’). It can be tired, but if the baby’s
in bed with you, you may find you get used to feeding without totally waking up, and manage to get pretty decent rest even
with nursing 3-4 times a night.- if you have any time off available, take a nursing holiday. Set yourself up with lots
of nutritious snacks, big bottles of water, and you and baby go to bed for the day and just nurse as much as possible. Increases
supply, great stress-buster, and remember, this is totally justifiable because you’re saving money not buying formula!

4.
Pump efficiently – mostly this means RELAX while you’re pumping. It’s
so hard when you’re worried about pumping enough, but relaxation is the number one way to increase your pumping output.
Sometimes herbs can help this – the Bach flower essences Rescue Remedy is a well known let-down enhancer for pumping.
Also - #1 tip – Don’t Look at the Bottles! Read an article online, stare out the window, but for some reason,
watching the bottle and counting ounces is the number one way for me to abruptly halt a letdown. Close your eyes if you have
to. Picture waterfalls, milk trucks spilling on the highway, whatever it takes. Also – check your pump parts. A
sudden drop in supply can be as easy to fix as new valves for your pump. The little while valves need to be replaced about
every six months.

5. Feed your body. There are three primary ingredients
in breastmilk – water, protein and fat. Be sure your body has enough of these to make milk. For some reason, the fat
is pretty efficiently moved from your butt, belly and thighs into the milk even if you don’t have much in your diet
(hooray for biology!), but protein and water are different. You need a pretty high daily intake of protein and water to keep
milk production up. Try keeping peanuts in your desk, or bringing hard-boiled eggs with your lunch. And be sure you have a
big water cup or bottle that sits on your desk at the ready all day.

6. Look for other
reasons supply is down – are you sick? Under a lot of stress? If so, your supply will likely bounce
back up once the situation resolves. Another reason for a major unexpected drop in supply is that you’re about to get
your period. This can last 3-4 days and is crazily frustrating. Try to pump more, and look for a big increase as soon as your
flow starts.

7. Use galactogogues. A galactogogue is any substance that
increases milk production. Here are my favorites:- More Milk tincture – 1 dropperful per hour till supply increases.
Then decrease until supply is maintained. Take in a little cup of water, it’s nasty. Use More Milk Two if you’re
pregnant.- fenugreek – 3 capsules 3 times a day until you smell faintly of maple. Don’t use if you’re
pregnant.Can increase dose to 3 capsules 5 times a day.More effective if used in combination with Blessed Thistle.- Mother’s Milk tea – 3 cups/day
– I found this didn’t really increase supply so much as maintain it. Lots of honey, also nasty.- Alfalfa tablets
– also a great laxative to counteract the prenatal vitamins! 2 capsules 2x/day.- other herbs – blessed thistle
(not milk thistle), nettle, fennel, anise. B vitamins can also help. Hops are good galactogogues as well, but I think they
don’t just mean in beer. Avoid peppermint and wintergreen as some people think these can decrease supply.

8.
Last resort – medications. Reglan used to be the drug of choice for milk
supply issues, but now that domperidone is available in the US, it is preferred. Domperidone has fewer side effects, and is
considered very safe for nursing mothers. You should know when you request these drugs that using them to increase milk supply
is considered “off-label” use. This means that the FDA has approved the drugs for other uses, but not increasing
milk supply. It is legal and safe to prescribe drugs for off-label use, but your doctor may not be able to find information
in the standard references.